| The resident of a rural area. A positive history of long-term exposure to domestic pets. No record of vaccination. No significant past medical history. Never underwent any kind of surgery in the past. |
| Date | Summaries from Initial and Follow-up Visits | Diagnostic Testing | Interventions |
| 30-01-2018 | First visit at basic health Unit of Dera Ismail KhanChief Complaints:Exacerbation of chest pain with worsening dyspnea.The patient also complained of fever.Physical Examination:A hemodynamically unstable patient with decreased chest movements and breath sounds on the right side with a dull percussion note in comparison to left hemithorax examination. There were no additional sounds.Diagnosis:Right-sided pyothorax | Plain chest X-ray revealed white out of the right lung. | Right-sided tube thoracostomy |
| 05-02-2018 | Follow-up at basic health unit Dera Ismail Khan: No improvement, and symptoms worsening over time. The output of the chest drainage unit was nil with absent air leakage. The patient was referred to Nishtar Medical University Hospital Multan for further evaluation and management. | Repeated chest X-ray showed similar findings. | |
| 06-02-2018 | The patient was admitted to the Thoracic Surgery Department of Nishtar Medical University Multan, in order to be re-evaluated and furtherly assessed. Subsequently, an extensive workup revealed the diagnosis of hydatid disease. He was operated one day later and had an uneventful recovery. He was discharged on the third postoperative day. | Baseline laboratory investigations were performed. Chest CT scan was also ordered which showed a large hydatid cyst with multiple daughter cysts. Anti-hydatid IgG antibodies also came positive | Right-sided thoracotomy for evacuation of multilocular hydatid cystic mass.Chest physiotherapy and incentive spirometry were advised. |
| 17-02-2018 | First follow-up visit after surgery. The patient was asymptomatic with no air and fluid leak from the chest drainage unit. Plain chest radiograph revealed expanded lung fields with a minor pleural effusion. | Repeated chest X-ray | |
| 19-03-2018 | Second follow-up visit after surgery. The patient remained asymptomatic with fully expanded lung fields and resolution of pleural effusion. | Chest X-ray | |
| 20-09-2018 | Third follow-up visit. The patient was asymptomatic. There was no recurrence of the disease. | Chest X-ray | |